Healthcare Provider Details

I. General information

NPI: 1962783738
Provider Name (Legal Business Name): NORMATIVE SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2011
Last Update Date: 09/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 LANE LN
SHERIDAN WY
82801-8630
US

IV. Provider business mailing address

5 LANE LN
SHERIDAN WY
82801-8630
US

V. Phone/Fax

Practice location:
  • Phone: 307-674-6878
  • Fax:
Mailing address:
  • Phone: 307-674-6878
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3245S0500X
TaxonomyChildren's Substance Abuse Rehabilitation Facility
License Number6190
License Number StateWY

VIII. Authorized Official

Name: CAROLYN WILLANDT
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 307-674-6878